Predictors of Normalization of Circulating Interleukin-6 after Cardiac Myxoma Resection

Yuan, Shi‐Min; Lin, Hao

doi:10.21470/1678-9741-2018-0161

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…In fact, IL-6 may be a more sensitive biomarker than C-reactive protein in predicting the inflammatory status of patients with cardiac myxomas. Sessile, irregular and voluminous tumours tend to be associated with higher circulating IL-6 levels[ 80 ]. Myxomas occasionally present with pyrexia of unknown origin[ 79 , 81 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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Cardiac myxomas are common primary neoplasms of the heart. They are biologically benign but “functionally malignant” because of the potential for embolization. They arise most commonly from the left atrium, but no chambers of the heart are immune. They may be sporadic in the majority but also familial as a part of the Carney complex. Two morphological forms exist: polypoid and papillary. Polypoid myxomas often present with obstructive features, while the papillary forms are more prone to embolization. Histogenesis is still controversial; the current view centres around origin from the primitive pluripotent mesenchymal cells. They may be of giant proportion, be calcified or get infected. Clinical presentation typically involves the triad of intracardiac obstruction, embolic events and constitutional symptoms. Precordial examination findings may simulate those of mitral or tricuspid stenosis. The presence of tumour plop and change of the physical findings with changing position may help differentiation between the two. Echocardiography is the investigation of choice. Echogenic polypoid or papillary mobile mass within the atrial cavity remaining attached to the interatrial septum through a stalk are the tell-tale echocardiographic features. Cardiac magnetic resonance and computed tomographic scanning may have incremental diagnostic value. Histopathological examination reveals abundant loose myxoid stroma with scattered round, polygonal or stellate cells with dense irregular nuclei. Genetic testing may detect mutations in the PRKAR1A gene in the familial form of cardiac myxoma, i.e. the Carney complex. Surgical excision is the mainstay of treatment with low operative mortality, excellent postoperative survival and low recurrence rate. The current trend favours minimal-access surgery with or without robotic assistance. Physicians should have appropriate preparedness to make a timely diagnosis and enthusiastic treatment to avoid potentially fatal complications.

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Section: Introductionmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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“…The normalization of circulating IL-6 levels can be of value in the follow-up of patients after cardiac tumor resection. 10…”

Section: Discussionmentioning

confidence: 99%

Oncotic (Myxomatous) Aneurysms: A Review of Management

Peres

Brito

Peres

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Atrial myxomas are the most common primary cardiac tumors and may manifest with neurological symptoms in ∼ 30% of cases. Cerebral ischemia, aneurysmal formation, and extravascular metastases are mechanisms that lead to these neurological manifestations. Perilesional changes on computed tomography (CT) and magnetic resonance imaging (MRI) may help in the diagnosis of myxomatous aneurysms, which are usually located in the distal middle cerebral artery (MCA) and in the posterior cerebral artery (PCA) circulation territories. Careful resection of the cardiac lesion is essential for preventing embolism. However, treatment of myxomatous aneurysms is controversial due to the limited understanding of the natural history of this condition. Treatment may include clinical observation in asymptomatic patients, surgical resection, endovascular approaches, adjuvant chemotherapy, and low-dose radiation therapy. We present one case of a female patient with myxomatous aneurysm secondary to an atrial myxoma who presented with neurological symptoms and another case of a female patient who developed neurological symptoms after initial surgical treatment of the primary lesion. Lesion growth rate, topography, morphology, and the patient's clinical condition must be considered when choosing a therapeutical method. Further clinical studies are needed to achieve a better understanding and treatment of this disease.

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“…Moreover, we found that in approximately 1 out of 5 myxomas inflammatory elements were identified. A study showed that increased levels of interleukin-6 found, either in the bloodstream or inside the tumor, can be used as a biomarker more efficiently than common infection markers, such as C-reactive protein [ 11 ]. Further research is indispensable in order to delineate the myxoma's biological behavior, especially in the field of inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Autopsy of 54 cases of surgically excised cardiac myxomas. Investigation of their impact on immune response

Michopanou

Schizas

Charitos

et al. 2020

Heliyon

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Introduction The impact of cardiac myxomas on the immune response is still indefinite, although laboratory tests and histological findings suggest that there is a correlation between myxomas and inflammatory reaction. Objectives Our study speculates that cardiac myxomas are associated with inflammatory response and investigates potential elements of inflammation in the histopathological examination and biomarkers from laboratory tests. Methods It is a retrospective study and data were collected from a single center between May 2010 to May 2018. Autopsies and laboratory tests of 54 cases were analyzed. Results In 20,4% of the autopsies, inflammatory elements were identified. The neutrophil/lymphocyte ratio (NLR) preoperatively is elevated in patients suffering from cardiac myxoma while its value is correlated to the tumor size. Conclusions Cardiac myxoma is an entity that affects the immune response of patients. The biomarker NLR could be utilized as a prognostic factor regarding enlarged cardiac myxomas. Future studies still need to be conducted in order to confirm the usefulness of this biomarker on cardiac myxomas.

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Predictors of Normalization of Circulating Interleukin-6 after Cardiac Myxoma Resection

Cited by 7 publications

References 20 publications

Cardiac myxomas: A narrative review

Cardiac myxomas: A narrative review

Oncotic (Myxomatous) Aneurysms: A Review of Management

Autopsy of 54 cases of surgically excised cardiac myxomas. Investigation of their impact on immune response

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